There are a number of systemic diseases associated with an increased risk for periodontal disease. Professor Philip Preshaw presented the latest statistics and evidence of the relationship between obesity, diabetes and periodontal disease.
Antioxidant rich foods
Vegetables: sweet potato, carrots, red and yellow peppers, leeks, courgettes, tomatoes
Fruits: apricots, mango, cantaloupe melon, pink grapefruit, avocados
Nuts: brazil nuts, almonds, cashews, mixed nuts and raisins, hazelnuts Seeds: sunflower, sesame, pumpkin, tahini paste
Oily fish: salmon, mackerel, herring, tuna, sardines, trout Meat: Beef, chicken, pork
Nutrition risk factor check list:
Medical history: check for risk of diabetes, cardio-vascular disease, digestion and absorption issues such as Crohn’s, diverticulitis and IBS
Dietary habits: reduce/avoid: refined foods, sugars, saturated fats. Increase: fruit, vegetables, lean protein, nuts, seeds, oily fish and wholegrains
Lifestyle: smoking, alcohol consumption, sedentary lifestyle, exposure to sunlight, isolation/ loneliness in older people
The World Health Organisation (WHO) reports that rates of obesity worldwide have tripled since 1975 with 39% of adults aged 18 and over being classified as overweight and 13% of adults being obese.9 28% of the UK adult population has been classified as obese.10
The cause was identified as increased energy intake from foods dense in fat, sugar and salt. This coupled with a decrease in physical activity and the sedentary nature of many forms of work, has led to the statistics seen today.
The relationship with periodontal disease is associated with shared factors in the immuno- inflammatory cascade. The association is mediated by adipose tissue which acts like an endocrine organ producing leptin and contributing to elevated levels of pro-inflammatory cytokines, such as tumour necrosis factor (TNF) and interleukin-6 (IL-6).11
Being overweight has been positively associated with periodontitis in adults12 with a 35% increased risk in obese patients13 and a three fold increased risk in type 2 diabetes patients.14 Diabetes impacts on the ‘whole person’ and research shows that patients with diabetes and severe periodontal disease are three times more likely to develop end stage renal failure15 and have a higher risk of death from ischaemic heart disease.16
The treatment of periodontal disease is associated with a reduction in HbA1c.17 Each 1% reduction in HbA1c is associated with a 21% reduction in deaths related to diabetes and a 37% reduction for myocardial complications.18 This reinforces the European Federation of Periodontology (EFP) manifesto call to all dental professionals to act in the prevention, early diagnosis and effective treatment of periodontal disease in order to combat the devastating oral and general health effects for the individual and society.19
The Joint EFP-IDF workshop on perio diabetes20 highlighted the role the dental team can play in treating the diabetes patient and the advantages of interdisciplinary care amongst the dental and medical professions.21